ArticleFrontiers in public health2026
Extended working hours, income, and multidimensional wellbeing among physicians in China: a cross-sectional mediation analysis.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Physician wellbeing is central to healthcare workforce sustainability, particularly in settings characterized by high work demands and extended working hours. In China's healthcare system, physician income remains an important occupational factor and may be linked to workload and service volume, adding complexity to the associations between working hours, income, and wellbeing. This study examined these associations and the potential mediating role of income among physicians in China. Methods: A cross-sectional survey was conducted among 1,324 physicians from four province-level regions in China. Physician wellbeing was measured across physiological, psychological, and work-related domains. Generalized Structural Equation Modeling (GSEM) with 5,000 bootstrap replications was employed to estimate the direct associations between weekly working hours and multidimensional wellbeing and the income-mediated indirect associations. Results: The mean score for physiological wellbeing (EQ-VAS) was 70.2 ± 16.7. Overall, 42.3% of physicians reported poor psychological wellbeing, defined as anxiety or depression, and 72.4% did not meet the criteria for good work-related wellbeing. Longer weekly working hours were inversely associated with physiological wellbeing ( Conclusion: Among physicians surveyed in China, longer weekly working hours were associated with poorer multidimensional wellbeing. Monthly income played a modest statistical mediating role in the associations with physiological and psychological wellbeing, while the corresponding indirect association was not evident for work-related wellbeing under the primary strict definition. Further longitudinal and policy-evaluation studies are warranted to inform work-hour management and compensation reforms.
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